From a clinical point of view it is extremely difficult to define the syndrome of premature ejaculation. Most definitions refer specifically to the duration of intravaginal containment of the penis. For teaching purposes a genitourinary service in a medical centre has described a premature ejaculator as a man who cannot control his ejaculatory process for at least the first 30 seconds after penetration. In similar vein a hospital psychiatric service has described the premature ejaculator as a man who cannot repress his ejaculatory demand for one full minute of intravaginal containment.

More realistically, a definition of premature ejaculation should reflect socio cultural orientation together with consideration of the prevailing requirements of sexual partners rather than an arbitrarily specific period of time.

30 to 60 seconds of intravaginal containment is quite sufficient to satisfy a woman.

If she has been highly excited during precoital sex play and is fully ready for orgasmic release with the initial thrusts of the penis. However, during most coital opportunity, the same woman may require variably longer periods of penile containment before attaining full release of sexual tension.

While readily admitting the inadequacies of the definition, the clinic considers a man a premature ejaculator if he cannot control his ejaculatory process for a sufficient length of time during intravaginal containment to satisfy his partner in at least 50 percent of their coital connections. If the female partner is persistently non orgasmie for reasons other than rapidity of the male's ejaculatory process, there is no validity to the definition. At least this definition does move away from the "stopwatch" concept.

The male's level of concern for an uncontrolled ejaculatory pattern and the concomitant depth of his female partner's sexual frustrations tend to increase in direct parallel to the degree of their formal education.

For instance:
grade-school or early high school dropouts rarely request relief from premature ejaculation. In this socio cultural setting the man generally dominates the pattern of sexual function within the couple, and his sexual satisfaction is the major concern.

Rapidity of ejaculation is not considered a sexual hazard, and in fact may provide welcome relief for the woman accepting and fulfilling a role as a sexual object without exposure to or personal belief in the concept of parity between the sexes in the privileges and the pleasures of sexual functioning.

Rapid release from sexual service frequently is accepted as a blessing by women living in the restrictive levels of this subculture's inherent double standard. Of course these women are free to enjoy orgasmic expression if it develops, but neither partner usually considers it the man's responsibility to aid or abet woman's sexual responsivity. (It should be noted that clinic and clinical studies have been extremely limited in material of cross-cultural or racial significance.)

The complainee in the couple contending with an established pattern of premature ejaculation usually is the female partner. If the male ejaculates regularly during premounting sex play or during attempts at mounting, or even with the first few penile thrusts after intravaginal containment, there rarely is opportunity for effective female sexual expression.

Time and again women's sexual tensions are elevated by precoital sex play, further edged by the additional stimulation of the penetration process, only to be confronted with almost instantaneous ejaculation and subsequent loss of penile erection. There is a high level of female frustration, particularly when this male response pattern is repeated routinely lime after time.